Recently, Robert F. Kennedy Jr. made a series of statements regarding measles and vaccination that have sparked significant discussion among public health experts. In an opinion piece published by Fox News, Kennedy asserted, “Vaccines not only protect individual children from measles but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons.” He emphasized that the decision to receive the vaccine should be a personal choice. However, experts in infectious diseases have raised concerns about the implications of his comments during the ongoing measles outbreak.
Dr. Shira Doron, the chief infection control officer for Tufts Medicine, critiqued the lack of a strong endorsement for vaccination from the nation’s top public health officials in light of the current crisis. “Some vaccines could be a personal choice. For example, even the CDC leaves some leeway on certain vaccines,” Doron explained, referencing the Respiratory Syncytial Virus vaccine, which is recommended for specific age groups. However, she stressed the importance of high vaccination rates for measles due to its highly contagious nature. “Because measles is so contagious — it’s the most contagious virus that we know — you have to have a very high rate of vaccination in your community,” she warned.
Measles is notorious for its signature red rash and its ability to infect 9 out of every 10 unvaccinated individuals exposed to the virus. Fortunately, it is also highly preventable. The MMR vaccine (measles, mumps, and rubella) requires two doses: the first is administered when children are between 12 and 15 months old, and the second between ages 4 and 6. This vaccine is reported to be 97 percent effective in preventing measles and offers lifelong immunity for most individuals. To achieve herd immunity against measles, a vaccination rate of 95 percent is necessary. However, in Texas, where measles has recently been spreading, only about 82 percent of the kindergarten population is vaccinated. Nationally, the CDC has reported that MMR coverage among kindergarteners has dropped below the critical threshold and continues to decline.
While the World Health Organization recommends vitamin A for all children with measles, this treatment is primarily administered in low-income countries where malnutrition is prevalent. In the United States, where less than 1 percent of the population is vitamin A deficient, there is no clinical evidence to support the claim that vitamin A can reduce mortality or the severity of measles. Dr. Alfred Sommer, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, stated, “We’ve never done a trial in the U.S., so I can’t tell you for certain whether it’s beneficial or it’s not.”
The American Academy of Pediatrics notes that “many US experts concur with administering vitamin A to all children in the United States with measles, regardless of hospitalization status.” They also highlight that children with more severe cases of measles may have lower vitamin A concentrations. However, it’s crucial for parents to consult healthcare professionals before giving vitamin A to children, as overdosing is possible. Kennedy recently claimed in a Fox News interview that children with measles in Texas were being given cod liver oil, which is high in vitamin A. Dr. Doron expressed skepticism about this assertion, stating, “You would not administer vitamin A that way.”
Vitamin A and general nutrition have long been promoted by anti-vaccine activists as alternatives to vaccination for disease prevention. Kennedy's claims have drawn criticism from experts like Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Of course, a balanced diet is very important for health, but a nutrition-rich diet alone will not stop the most contagious disease in the world from infecting an unvaccinated child,” Osterholm emphasized.
Dr. Doron echoed these sentiments, advising that while maintaining a healthy lifestyle can bolster the immune system, even the healthiest individuals can contract infectious diseases. She also criticized Kennedy’s historical framing of measles mortality, arguing that it’s not just about percentages but absolute numbers. “We were seeing 400 to 500 deaths a year prior to the introduction of vaccination, along with permanent disabilities in children due to measles,” she said. Long-term complications from measles can include deafness, lung scarring, and potentially fatal brain damage.
“MMR vaccines and other vaccines are safe,” stated Dr. Vandana Madhavan, a pediatric infectious disease specialist at Mass General for Children. Unfortunately, misinformation surrounding vaccines has contributed to increased vaccine hesitancy. “If vaccine skepticism continues to spread, we’re going to see more outbreaks of diseases that had become rare in the U.S.,” Madhavan warned. As the debate continues, the consensus among public health experts remains clear: vaccination is essential to protect individual children and the broader community from the serious threat posed by measles.
